CN115605155A - Control interface and robot system comprising such a control interface - Google Patents
Control interface and robot system comprising such a control interface Download PDFInfo
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- CN115605155A CN115605155A CN202180031434.6A CN202180031434A CN115605155A CN 115605155 A CN115605155 A CN 115605155A CN 202180031434 A CN202180031434 A CN 202180031434A CN 115605155 A CN115605155 A CN 115605155A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/37—Master-slave robots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/72—Micromanipulators
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/74—Manipulators with manual electric input means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/74—Manipulators with manual electric input means
- A61B2034/742—Joysticks
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
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Abstract
The invention relates to a control interface (I) for a robotic system for vitreoretinal surgery, comprising a haptic device (1) equipped with an articulated chain (2) having a free end (3), characterized in that it comprises a guide device (10) comprising: -a fixed surface (11), -a guide means (20) mounted on the fixed surface by means of a ball joint (21), -a rod (30) mounted on said guide means (20) by means of a sliding connection (25) having an axis corresponding to the axis of the rod (30), said rod comprising a first end (32) fixedly mounted on the free end (3) of the haptic device (1) and a second end (33) on which the grip member (5) is intended to be mounted.
Description
Technical Field
The present invention relates to the field of robotic platforms that allow performing vitreoretinal surgery.
Background
Vitreoretinal surgery requires the insertion of surgical instruments into the eye of a patient. Traditionally, surgical instruments are inserted into the anterior portion of the patient's eye in a horizontal position using a hollow, sharp cylindrical rod called a trocar. By inserting the instrument into the trocar, it passes through the sclera of the eye, then through the vitreous, and then to the back of the eye where the retina is located. The surgeon cannot have a trocar. The trocar contains a valve that prevents fluid leakage while allowing the depth and orientation of the tool in the eye to be easily changed. It is therefore through the point around which the surgeon performs the movements with the instrument to position it properly on the retina.
Vitreoretinal surgery requires intervention on structures that may be only tens of microns in size. Surgeons must be very dexterous and often find themselves in uncomfortable positions. Some operations are even not feasible, requiring capabilities beyond human limits.
Document US 10,271,914 B2 discloses a robotic system 100 for vitreoretinal surgery. The robotic system 100 includes a robotic platform 126 to which the surgical instrument 114 is attached and a haptic device 118 for manipulating the robotic platform 126. The robotic platform 126 includes an end effector that allows control of the instrument in four or six degrees of freedom, which is capable of performing at least translational and rotational motions about its axis. Haptic device 118 provides positional feedback, allowing the surgeon to remotely control the motion of robotic platform 126 using stylus 122. The movement that can be performed with stylus 122 is not limited in any way. Thus, some action by the surgeon with stylus 122 is not possible due to the fact that instrument 114 is constrained by its passage through the trocar.
Document US 6,063,095B discloses a robotic system 10 comprising a robotic platform consisting of a set of robotic arms 26 to which a surgical instrument is to be attached, and a system for controlling the robotic platform. The control system includes two control members 50, 52 allowing remote control of the movements performed by the robotic arm 26. The control members 50, 52 may be mounted on the portable cabinet 54 or the support 900. In both cases, a set of joints JM1-JM5 allows the control members 50, 52 to make translational and rotational movements about their respective axes and to change their orientation. Each joint is associated with a position sensor (e.g., a potentiometer) to determine the final position of the control members 50, 52. This document does not disclose exactly how position sensor data is processed to control the robot arm 26. In any case, neither control member 50, 52 is associated with any haptic device.
To use these systems, the surgeon may need to receive training in the manipulation of the articulated arm, which is very different in nature from the operations performed using the surgical instruments. Furthermore, the transition from conventional operation to robotic system-assisted operation may be confusing to the surgeon because he or she must readjust each time he or she changes the mode of operation.
Disclosure of Invention
The present invention aims to overcome the above-mentioned problems and proposes for this purpose a control interface for a robotic system for vitreoretinal surgery, comprising a haptic device equipped with an articulated chain having a free end, characterized in that it comprises a guide device comprising:
the surface of the fixed plate is fixed,
a guide means mounted on the fixed surface by a ball joint,
a rod mounted on said guide means by means of a sliding connection having an axis corresponding to the axis of the rod, said rod comprising a first end fixedly mounted on the free end of the haptic device and a second end on which the grip member is intended to be mounted.
When the surgeon uses the control interface according to the invention, he or she performs the same operation as if he or she were dealing with the surgical instrument itself. In fact, when the surgeon manipulates the gripping member, the action exerted thereon is reproduced by the surgical instrument at the end of the chain.
In this respect, the arrangement of the rod with respect to the fixed surface plays a central role in the transmission of the movement performed by the gripping member. With the rod mounted on the guide by means of a sliding connection and the guide itself mounted on a fixed surface by means of a ball joint, the rod is constrained in the same way as the passage of the instrument through the trocar is constrained. Thus, its concavity and orientation may vary, but it will always be constrained to pass through the same point (the center of the ball joint). Thus, in addition to the depression/retraction movement and the orientation change, a rotational movement of the rod about its axis can be performed.
Since the first end of the rod is fixedly mounted on the free end of the haptic device, these translational movements along the axis of the rod and rotations about the axis of the rod are then transmitted to the haptic device dependably. The haptic device can then measure them.
Of course, when referring to surgical instruments, this refers to a variety of surgical instruments that may be used for vitreoretinal surgery.
According to various features of the invention which may be considered together or separately:
the control interface comprises said grip member, the grip member and the lever respectively comprising detection means adapted to detect the pressure exerted by the user on said grip member,
the first sensing device is a magnet, the second sensing device is a hall effect sensor,
the gripping member comprises a deformable gripper and a movable portion on which said magnet is fixedly mounted, said movable portion being displaceable when the gripper is deformed,
the rod is in the form of a hollow body, which internally delimits a housing,
said second detection means are arranged in the housing,
the fixation surface comprises an opening and the guiding means comprises a spherical member and an adapter element for the spherical member in the opening, the adapter element and the spherical member forming a ball joint,
the rod is cylindrical, the spherical member is hollow and has a sliding bearing matching the shape of the rod to form a sliding connection,
the lever comprises supply means for second detection means arranged in the housing, said supply means being electrically connected to the second detection means and being able to receive an electrical signal emitted by the second detection means when a user exerts a pressure on said grip member,
the guide means comprises a rotary collector arranged coaxially around the rod, said collector comprising an inner ring attached to the rod and an outer ring attached to the shaft of the articulated chain, the free end of the haptic device being located on the shaft of the articulated chain,
the control interface includes a sterile cover between the grip member and the second end of the rod.
The invention also relates to a robotic system for vitreoretinal surgery comprising:
a robotic platform comprising at least one robotic arm intended for carrying at least one surgical instrument, said robotic arm comprising an actuation module comprising at least one actuator,
a console comprising a control interface as described above,
a therapy module connected to the control interface and the actuation module by a communication network, the therapy module comprising at least one processor, memory, and software for analyzing measurements performed by the haptic device and for calculating and providing motion set points to the robotic arm,
the platform is configured such that motion imparted to the shaft is reproduced on the surgical instrument by the robotic arm.
Preferably, the robotic system is configured such that the pressure exerted on the gripping member and the movement exerted on the gripping member are reproduced by the surgical instrument by means of the robotic arm.
Drawings
Other objects, features and advantages of the present invention will become more apparent in the following description with reference to the accompanying drawings, in which:
FIG. 1 illustrates a perspective view of a control interface according to the present invention;
figure 2 shows a perspective cross-sectional view of a guide device for a control interface according to the invention;
FIG. 3 is a schematic view of a control interface according to the present invention showing various kinematic connections interconnecting components to one another;
FIG. 4 illustrates a perspective view of a gripping member suitable for use in a control interface according to the present disclosure;
FIG. 5a shows a surgeon manipulating the gripping member;
FIG. 5b is a schematic view of a control interface according to the present invention, specifically equipped with a lower-hand mechanism;
FIG. 6 is a schematic view of a control interface according to the present invention, showing mechanical connections in a guidance device;
FIG. 7 is a schematic diagram of the calculations and data transfer between the control interface and the robotic platform.
Detailed Description
With reference to fig. 1, the present invention relates to a control interface I of a robotic system SR for vitreoretinal surgery.
The robotic system SR in question is intended for use by a practitioner, in particular by a surgeon in the context of a vitreoretinal surgical procedure (only its control interface is shown in the example of embodiment shown in fig. 1). It comprises a robot platform PR comprising at least one robot arm BR for manipulating a surgical instrument. Preferably, the robotic platform PR comprises two robotic arms BR allowing for simultaneous manipulation of at least two surgical instruments. Furthermore, each robot arm BR may comprise a module for actuating said robot arm BR. The actuation module includes a plurality of actuators adapted to control the robotic arm.
Furthermore, the robotic system SR comprises at least one control interface I associated with the robotic arm BR, it being understood that if the robotic platform PR comprises two robotic arms, the robotic system SR comprises at least one control interface, preferably two control interfaces I, each associated with one robotic arm BR. In the example of embodiment shown in fig. 1, the robot system SR comprises two control interfaces I.
Furthermore, the robotic system SR comprises a processing module MT which is able to receive and process measurement data received by one or more control interfaces I in order to generate a movement of the surgical instrument from a movement operated with the one or more control interfaces. This processing module will be described in more detail in the description related to fig. 7.
The surgical instrument is any surgical instrument that can be used for vitreoretinal surgery. It is understood that the instrument is adapted to pass through a trocar. By way of background, a trocar is a hollow, pointed cylindrical shaft extending along a longitudinal axis. The instrument can not only be passed through a trocar, but can alternatively or in combination cut, cauterize, inject, aspirate, etc. In this regard, a practitioner is often required to perform a pinch to operate the instrument, i.e., he/she performs cutting, cauterization, injection, aspiration, etc., of the instrument by a gesture of the pinch. Hereinafter, movement of the surgical instrument is described relative to the longitudinal axis of the trocar.
The control interface I comprises a haptic device 1, a guide device 10, and a grip member 5, advantageously detachably mounted on the guide device.
The haptic device 1 is a force feedback device that allows highly accurate positioning measurements in space. In other words, the purpose of the haptic device 1 is to measure positions with a very high confidence level.
In this respect, it comprises an articulated chain 2, the articulated chain 2 comprising a plurality of articulated arms 2a connected to each other by joints 2b, the joints 2b being designed to allow the articulated chain 2 to move in all degrees of freedom. The articulated chain comprises at least two articulated arms 2a. Each joint 2b is equipped with its own motor which allows the generation of force. Each joint 2b comprises its own angular position sensor which allows to measure its position. One end of the articulated chain 2 is connected to a support 4, which is preferably fixed with respect to the console 60, as will be described in more detail in the description with respect to fig. 5 b. As will be seen in more detail below, the free end 3 of the articulated chain is attached to a guide apparatus 10. The haptic device 1 thus comprises all the elements between the free end 3 and the support 4, including the free end 3 and the support 4.
The guiding device 10 comprises a fixed surface 11, a rod 30 and guiding means 20, the surface 11 and the rod 30 cooperating through the guiding means 20.
The fixing surface 11 allows to ensure the retention of the guide means 20, i.e. it provides a mechanical support. It is fixed with respect to the support 4 of the haptic device 1. In other words, there is no movement of the guiding device 10 relative to the haptic device 1. Which is integrated into the console 60 described above and is fixed relative to the console 60.
In the example of embodiment shown in fig. 1, the fixing surface 11 is planar. However, this is in no way limiting, as the fixation surface 11 may also have any other shape, e.g. curved. It is important that the fixation surface 11 ensures that the guiding means 20 holds the guiding means 20 while being fixed with respect to the support 4 of the haptic device 1.
As previously mentioned, the rod 30 cooperates with the fixed surface 11 through the guide means 20.
In this respect, the guide means 20 are mounted on the fixed surface 11 by means of a ball joint 21, while the rod 30 is mounted on said guide means 20 by means of a sliding connection 25, the axis of the sliding connection 25 corresponding to the axis of the rod 30. By being arranged in this way with respect to each other, the bar 30, the guide means 20 and the surface 11 form a sliding ball joint which will be described in more detail below.
Incidentally, the rod 30 of the guiding device can be manoeuvred in a change of directional movement around the ball joint 21, in a rotational movement around the axis of the rod and in a translational movement with an axis corresponding to the axis of the rod. In this context, the shaft 30 is comparable to the shaft of a surgical instrument used in vitreoretinal surgery from the perspective of the surgeon. The rotary motion of the rod 30 about its axis, i.e. of the rod 30 itself, corresponds to the rotary motion of the instrument itself. Movement to change the orientation of the shaft 30 corresponds to a change in the orientation of the instrument and the axis of the trocar in the patient's eye, where the trocar necessarily follows the change in orientation of the surgical instrument. This is because the trocar is in ball engagement with the eye. Finally, the translational movement of the rod 30 along its axis corresponds to the pressing/retraction of the instrument into/from the trocar, the depression or removal depending on the direction of the operative translational movement. That is, the rod 30 is always constrained to pass through the center of the ball joint, regardless of the motion being performed.
Furthermore, as shown in fig. 3, the rod 30 comprises a first end 32 fixedly mounted on the free end 3 of the articulated chain of the haptic device. The guide device 10 is thus connected to the haptic device 1 via the first end 32 of the rod. Since the first end 32 of the rod is fixedly mounted on the free end 3 of the haptic device 1, the joint 3 of the articulated chain 2 accommodates the movements performed by the rod 30. These movements are measured in an accurate manner and data from these measurements are transmitted to the therapy module MT.
By means of the joystick 30, the practitioner performs the same actions he or she would make if he or she were directly manipulating the instrument, whilst benefiting from the assistance provided by the robotic system SR.
However, in practice, the practitioner may advantageously control the movement of the lever 30 by means of the gripping member 5. The gripping member 5, which will be described in more detail in connection with the description of fig. 4, is similar in shape to the surgical instrument, which makes the experience of the practitioner more credible. In addition to having the same shape as a conventional surgical instrument, the gripping member 5 is also preferably sterile. The term "sterile" as used herein is in the medical sense, thus meaning that the gripping member 5 has been previously sterilized and is therefore sterile.
As shown in the example of embodiment shown in fig. 2, the lever 30 comprises a second end 33 on which said gripping member 5 is intended to be mounted. The rod 30 is thus rigidly connected to the gripping member 5, which allows to reliably transmit the movement of said gripping member 5 to said rod 30 when the gripping member 5 is present, while allowing the surgeon to have a sensation similar to that he or she would have when operating the surgical instrument.
With reference to fig. 2, the arrangement of the rod 30 within the guide apparatus 10 and the operation of the guide apparatus 10 are described more precisely.
The fixing surface 11 comprises an opening 12 and the guiding means 20 comprise a spherical member 23 which cooperates with the opening 12 by means of an adapter element 22 to form a ball joint 21. The adapter element 22 is interposed between the opening 12 and the spherical member 23. It consists of a mechanical component comprising a cylindrical outer ring and a spherical inner housing within which the spherical member 23 is free to move. The dimensions of the adapter element 22 are selected such that the adapter element matches the shape of the opening 12 on the outside and the spherical member 23 on the inside. This configuration allows for changing the orientation of the rod 30, in particular because the spherical member 23 can move freely in the inner housing of the adapter element 22. Further, according to this structure, the center of the ball joint 21 is the center of the spherical member 23.
The above configuration is not limiting, and those skilled in the art may design the ball joint 21 in consideration of other configurations.
Preferably, the spherical members 23 are chrome steel spheres.
In the embodiment shown in fig. 2, the rod 30 is cylindrical in shape, while the spherical member 23 is hollow and has an interior 24 matching the shape of the rod 30 to form the sliding connection 25. For example, the interior 24 may includeThe finished sliding bearing. The inner portion 24 therefore has a cylindrical profile, the dimensions of which are chosen such that it fits as tightly as possible around the rod 30 without preventing the rod 30 from sliding. Again, the configuration shown is in no way limiting. Alternatively, the rod 30 could be provided in the form of a straight block, and then the inner surface 24 would have a profile in the form of a hollow block. There are many other ways to realize the sliding connection 25 between the spherical member 23 and the rod 30, within the abilities of the skilled person, without however going beyond the inventive concept of the present invention.
By combining the ball joint 21 and the sliding connection 25, a sliding ball joint is formed which allows the practitioner to simulate the retraction/depression movement of the surgical instrument through the trocar, the change in orientation of the surgical instrument and the axis of the trocar, and the rotational movement of the surgical instrument about that axis, the change in orientation of the axis acting as a cue to follow the movement along the change in orientation of the intraocular surgical instrument.
As further shown in fig. 2, the rod 30 is advantageously in the form of a hollow body, internally delimiting a housing 34. In other words, the rod 30 itself is therefore generally in the form of a hollow cylinder. The housing 34 thus formed advantageously allows housing the second detection means 40, which cooperate with the first detection means 6 contained in the grip member 5. The housing 34 also allows to house supply means 41 for the second detection means 40. The relevance of the first and second detection means 6, 40 to the supply means 41 is described below in connection with fig. 4.
The supply means 41 of the second detection means 40 are preferably electric wires. In order to prevent the wire from twisting, i.e. from tangling, the guide device 10 advantageously comprises a rotating collector 44 arranged coaxially around the rod 30. The rotating collector 44 allows the wires 41 to be electrically connected to an electronic board 45, the role of which is to process the data coming from the second detection device 40. More specifically, it allows the wires 41 located in the bar, which is rotatable due to the sliding ball joint, to be electrically connected to the other wires 42 connected to the electronic board 45, the electronic board 45 remaining fixed with respect to the surface 11, unlike the bar 30. In this regard, it should be noted that the rod 30 includes an aperture 35 for passage of the wire 41 from the housing 34 to the collector 44.
Advantageously, the practitioner can perform multiple, say infinite, rotations of the lever 30 without the wire 41 becoming tangled. In this regard, the collector 44 itself is a pivotal connection. As schematically shown in fig. 3, the collector 44 comprises an inner ring 44a attached to the rod 30 and an outer ring 44b attached to the shaft of the articulated arm 2a, the free end 3 of the haptic device being located on the shaft of the articulated arm 2a. Means for preventing translation of the collector 44 relative to the rod 30 are also provided at the level of the rod. For example, such means may consist of protrusions arranged on the outer surface of the bar on both sides of the collector 44. This allows preventing the wire 41 from stretching and subsequently deteriorating.
With reference to the figures, and in particular to figures 1 and 4, the control interface I very advantageously comprises a gripping member 5. The use of the gripping member 5 has a number of advantages, which will be better understood hereinafter.
The gripping member 5 is not permanently mounted on the guide apparatus 10. Because it is detachably mounted on the guide apparatus 10. Thus, the manufacturer can sell the control interface I without the gripping member 5.
As shown in the example in fig. 4, the gripping member 5 is in the form of a stylus, which is similar in shape and size only to standard instruments used for vitreoretinal surgery. The gripping member 5 is not a surgical instrument and is not intended for direct use on a patient. It is a control device, i.e. it has a control function, in particular a kneading control. It works in conjunction with the rest of the control interface I to detect and measure kneading.
The gripping member 5 comprises, in sequence, an elongated section 9, a deformable gripper 8 and a movable portion 7 positioned side by side.
The substantially cylindrical elongate section 9 cooperates with the deformable grip 8 to provide the practitioner with a feel equivalent to the feel he would have when manipulating the surgical instrument. In fig. 4, only the outer envelope of the elongated section 9 is visible, but the elongated section comprises an invisible core extending far beyond the outer envelope, more precisely at least as far as the movable part 7, as will be seen below.
The deformable gripper 8 has a diamond shape, i.e. a double pyramid shape, wherein the pyramids have a common base BC and wherein one of the pyramids is truncated. The gripper 8 is thus formed by a full pyramid 8a and a truncated pyramid 8 b. The apex S of the full pyramid is located to one side of the elongate section 9, while the smaller base of the truncated pyramid, hereinafter referred to as the "further base" AB, is located in the vicinity of the movable portion 7. Each pyramid is formed by a plurality of tongues 8c which give the gripper 8 its deformable properties.
Furthermore, it should be noted that, although the further base AB of the truncated pyramid 8b is rigidly connected to the movable portion 7 by way of the narrowing section PRE, the further base AB and the movable portion 7 are movable with respect to the elongated section 9, in particular its core (not visible). In fact, both the further base AB and the movable portion 7 are slidingly connected with the core of the elongated section 9, which, although not discernible in fig. 4, extends at least to the movable portion 7. Such sliding connection, schematically shown in figure 3, is formed by openings implemented in the further base AB and in the movable portion 7, their respective openings being adjusted to the outer surface of the core of the elongated section 9, i.e. they are sized to form a sliding connection with the core of the elongated section 9.
In such a configuration, when pressure is applied at the level of the common base BC, the tongues 8c are thinner at the level of the base BC compared to their thickness at the level of the top S and of the other base AB, the grippers 8 are deformed, allowing the other base AB and the movable portion 7 to slide simultaneously along the elongated section 9. In this respect, the elongation of the gripper 8 may vary depending on the pressure applied and the position where the pressure is applied on the gripper 8. At constant pressure, the closer the support is to the common base BC, the more the gripper 8 deforms and therefore elongates. At the same time, for the same bearing position between the two manoeuvres, the higher the pressure applied, i.e. the higher the bearing rate, the more the gripper 8 is deformed and therefore elongated.
Thus, the bearing position, i.e. the position where pressure is exerted on the gripper 8, and the chosen exerted pressure, i.e. the bearing rate, influence the displacement of the movable part 7 and thus the desired level of kneading as will be seen below. Thus, when the practitioner presses the gripper 8, he can manipulate the gripping members 5, just like he manipulates the surgical instrument when he wants to perform a kneading, and adjust the position of his/her fingers with respect to the common base BC according to the level of kneading he wants to obtain below. This is shown in figure 5 a. The above configuration is just one example of using the grip member 5. Any other solution allowing the displacement of the movable part 7 to be generated when pressure is exerted on the gripper 8 can be envisaged by the person skilled in the art.
In other words, if the grip position and the grip rate determine the desired level of kneading, the manner of detecting and measuring the elongation will be explained below.
Very advantageously, the grip member 5 comprises detection means 6, hereinafter first detection means 6, which allow to detect the displacement of the movable portion 7. To this end, said first detecting means 6 are fixedly mounted on the movable portion 7, so that any displacement of the movable portion 7 along the core of the elongated section 9 automatically causes a displacement of the first detecting means 6. It should also be noted that once the gripping member 5 is mounted on the rod 30, the movable portion 7 also becomes movable with respect to the rod 30 and therefore with respect to the second detection means 40. This is important because the second detection means 40 of the guiding means 10 can detect the movement of the first detection means 6 and subsequently measure this movement by the second detection means. Thus, as long as sufficient pressure is exerted on the gripper 8 to displace the movable portion 7 and thus the first detection means 6, the displacement of the first detection means 6 can be measured by the second detection means 40. The first detection means 6 and the second detection means 40 thus cooperate to detect the pressure exerted on the gripping member 5. This gives the gripping member 5 its control function, in particular the control of kneading performed by the practitioner.
Preferably, the first detection means 6 are magnets and the second detection means 40 are hall effect sensors, more precisely, the magnets are permanent magnets. Thus, when sufficient pressure is applied on the gripper 8 to displace the magnet 6, the magnetic field of the magnet is displaced and therefore varies in the field of view of the hall effect sensor 40, which is reminded that the hall effect sensor 40 is located in the rod 30. Thus, the pressure rate can be inferred from the signal of the hall effect sensor.
The advantage of this configuration compared to another detection system is that the gripping member 5 is therefore free of electronic components, the whole electronic part being located in the rod 30 and therefore in the guide device 10. Therefore, even if it has no electronic component, the pressure applied to the gripping member 5 can be detected. Furthermore, the cost of the gripping member 5 can be kept low and can therefore be used more easily as a consumable. This ensures that the required sterilization conditions for the grip member 5 are met in each operation. Further, since the grip member 5 is a consumable without electronic components, it is easier to recycle.
Preferably, the hall effect sensor 40 is located at the level of said second end 33 in the housing 34 of the rod. This brings it as close as possible to the magnet 6, which enhances its ability to even detect movement of said magnet, even if the amplitude of the movement is small. Of course, the hall effect sensor 40 as well as the magnet 6 can be arranged in any other way as long as a change in pressure on the gripping member 5 can be detected. Advantageously, the housing 34 of the lever allows accommodating other types of sensors, according to the desires, giving the additional functionality of the control interface I according to the invention.
Furthermore, whilst the combination of the magnet 6 and hall effect sensor 40 has the advantages described above, other solutions are envisaged for detecting and measuring the pressure on the gripping member 5 by a practitioner. A Linear Variable Differential Transformer (LVDT) may be used. This type of sensor comprises a cylindrical transformer and a core and has a response proportional to the displacement of the core in the transformer. For example, strain gauges may be used. Strain gauges allow for the transformation of deformation of a component into a change in resistance. In other words, any sensor that allows providing position feedback may be used by the person skilled in the art.
The electrical signal SE from the hall effect sensor 40 is transmitted to the electronic board 45 via the line 41, the collector 44 and the line 42 for processing. The data of the sensors may be transmitted to the electronic board 45 by any other means known to those skilled in the art. The data processed by the electronic board 45 are then transmitted to the processing module MT which processes the data and sends specific set points to the robot platform PR so that the pressure exerted by the practitioner on the gripping member 5 can be reproduced on the surgical instrument by means of the robotic arm BR. Thus, the practitioner does not need to learn any new gestures to have the surgical instrument perform a pinch, as he manipulates the gripping member 5 in the same way as he would manipulate the surgical instrument itself.
As shown in fig. 5b, the control interface 1 may comprise a console 60. The console 60 consists of a height adjustable table in which the fixed surface 11, the guide means 10 and the rod 30 are integrated according to the previously described configuration. At the level of the surface 11, the console 60 is connected to the rest of the control interface I. In this regard, the fixed surface 11 may be integral with the console 60, or it may be a pre-assembled component that is pre-attached to the console 60. As shown in fig. 5a, when the surgeon is seated at the level of the control interface I, the console 60 allows to provide the necessary support and stability to be able to manipulate the rod 30 and, if necessary, also the grip member 5. The console 60 forms a physical boundary between the surgeon and the haptic device 1 because the haptic device 1 is located below the console 60.
Preferably, the console 60 has a wrist rest (not shown) against which the practitioner can rest to maintain stability. In addition, the console 60 may also include a height adjustable lower hand mechanism 62. The lower hand mechanism 62 may be placed below the gripping member 5 to facilitate gripping of the gripping member while accommodating the morphology of the practitioner. The lower hand mechanism 62 includes at least one support surface 62a and a torso 62b extending from the console 60. The height of the lower hand mechanism 62 can be adjusted by making a sliding connection between the trunk 62b and the console 60. Preferably, the sliding connection is motorized, which allows the height of the sub-hand mechanism 62 to be adjusted depending on the type of instrument used and the procedure being performed.
It should be noted that, with reference to fig. 3, the control interface I may also comprise a sterile cover 15. A sterile cover 15 may be interposed between the gripping member 5 and the rest of the control interface I. This allows maintaining a sterile environment from the second end 33 of the rod where the gripping member 5 is mounted to the patient. Thus, the cover 15 is a constraint that must be considered when designing the control interface I. The sterile cover 15 preferably comprises a sealing element (not shown) between the two portions.
Referring to fig. 6, the kinematics and geometry of the guide device 10 are described. A reference frame R0 having an origin O is associated with the guiding device 20. A reference frame R1 having an origin a is associated with a support 4 of the haptic device, which support 4 is preferably fixed with respect to the console 60. A reference frame R2 with an origin B is associated with the free end 3 of the articulated chain of the haptic device. A reference frame R3 having an origin T is associated with the rod 30. A reference system R5 having an origin P is associated with the elongated section 9 of the gripping member 5.
Point T corresponds to a point on the shaft 30 and the tip of a surgical instrument in the patient's eye. Thus, in order to change the position of the tip of the surgical instrument, the surgeon must change the position of point T in R0. To measure this position, an algorithm is implemented. This takes into account the geometrical transformation between the reference frames R0 and R1, R1 and R2, R1 and R3 and R2 and R3. As previously mentioned, the fixed surface 11 is fixed with respect to the support 4 of the haptic device 1, so the transformation between the reference frames R0 and R1 is constant and known by design. Similarly, since the free end 3 of the articulated chain is fixed with respect to the first end 32 of the rod, the geometrical transformation produced between R2 and R3 is constant and known by design. The geometric transformation between the reference frames R1 and R2 is measured by the haptic device 1. The geometric transformation between the reference frames R0 and R3 can be determined by calculations performed by the processing module MT.
A point P of the reference frame R5 is associated with the movable portion 7. After applying pressure to the gripping member 5, the position of the point P changes, and the gripper 8 deforms from the position of the point P when no pressure is applied to the gripping member 5. As previously mentioned, this reflects the level of kneading applied by the practitioner to the surgical instrument itself.
Measuring the positions of these two points T and P makes it possible to understand all the actions that a practitioner desires a surgical instrument located at the end of the chain to perform in the patient's eye. These actions may be performed by the robot platform PR in the same or an improved way. It should be noted that measuring the position of the point T only in the reference system R0 is sufficient to operate an instrument that does not require kneading, i.e. an instrument that only requires pressing/removing and changing of orientation. In performing the pinching, the gripping member 5 is required to measure the practitioner's pressure rate, and then a measurement of the position of the point P in the reference frame R5 is required to be performed.
In this respect, the options offered by the control interface I according to the invention are numerous. The ability of the haptic device 1 to generate force allows feedback to be provided to a practitioner. Indeed, the haptic device 1 allows:
the amplitude of movement of the restraining bar 30, which may be the amplitude of movement of the gripping member 5, in order to force the instrument to remain in certain areas,
the displacement speed of the rod 30 is limited, and the displacement speed of the gripping member 5 can be limited, to improve the accuracy and stability of the movement,
for material and/or safety reasons, the speed of the rod 30 and possibly of the gripping member 5 is adapted to the speed of the robot platform PR,
haptic feedback is provided based on the force measured by a sensor mounted at the level of the instrument on the robot platform.
In this regard, as shown in fig. 7, data transmission within the robot system is performed according to the following method.
Advantageously and as previously mentioned, the robotic system SR comprises a therapy module MT, which is connected to the control interface I and the actuation module via a communication network (not shown) as previously described. The therapy module is equipped with a processor and memory. It may be any type of electronic or computer processing device, such as a computer or any device equipped with a processor and a memory, as long as it allows processing of the data received from the haptic device 1 and the electronic board 45.
The processor is configured to analyze and/or process data obtained from the haptic device 1 and the electronic board 45. In this regard, treatment software may be installed on the processor to perform such treatment automatically and in real-time. The software comprises spatial and kinematic geometric algorithms which allow the spatial configuration adopted by the rod 30 and possibly by the gripping member 5 to be converted into set points for each actuator of the actuation module. These actuators act on the robot platform PR to control the surgical instruments. As described in the description of fig. 7, the software determines the location of point T in reference frame R0 and, if applicable, also the location of point P in reference frame R5. These algorithms allow the device to comply with its passage through the trocar. The algorithm advantageously allows to simplify the implementation of additional options that, as seen above, the practitioner can use by improving the initial pose performed by the practitioner.
The memory allows to receive and store, even temporarily, the data transmitted and processed by the processing module MT.
Arrow F1 indicates that the practitioner places the lever 30 and, if applicable, the gripping member 5 in a certain position and orientation, arrow F2 indicates that the practitioner pinches the gripping member 5 when the control interface I includes the gripping member 5, and arrow F3 indicates that the surgical instrument is placed in the same position and orientation as the lever 30 and, if applicable, the gripping member 5. Between event F1 and event F3, data transmission takes place between F1 and F2 together with F3 if necessary, as follows:
1) The data measured by the haptic device 1 and the electronic board 45 are transmitted to the therapy module MT (arrows F4, F4' and F9),
2) The processing module MT processes these data by means of algorithms of the software and converts the configuration adopted by the rod 30 and possibly by the gripping member 5 into set points (processes between F4 and F8, between F4 'and F8 and possibly between F4' and F9) for each actuator of the actuation module,
3) The set point is sent to the actuation module,
4) The actuation module controls the robotic platform so that the surgical instrument reproduces the movements performed by the surgeon (arrow F3).
The process between F4 and F8 will be described in more detail below. Between F4 and F5, the therapy module MT has received the rotation (given by the haptic device 1) existing between the reference frames R1 and R2. The processing module MT inverts it and combines it with the rotation (constant and known by design) present between the reference frames R3 and R2 to derive the rotation present between the reference frames R3 and R1. Between F5 and F6, the processing module MT uses the rotation between the reference frames R3 and R1 and the expression of the vector BT in the reference frame R3 (constant and known by design) to derive the expression of the vector BT in the reference frame R1. Between F6 and F7, the processing module MT receives the expression of the vector AB in the reference frame R1 (given by the haptic device 1) and adds it to the expression of the vector OA (constant and known by design) and to the expression of the vector BT (derived after F6). He derives the expression of the vector OT in the reference system R1. Between F7 and F8, the processing module uses the rotation present between the reference frames R1 and R0 (constant and known by design) and the expression of the vector OT in the reference frame R1 to derive the expression of the vector OT in the reference frame R0. This is exactly what data he needs to know about where the surgeon wants to provide the instrument with the position and orientation.
Claims (12)
1. A control interface (I) for a robotic platform for vitreoretinal surgery, comprising a haptic device (1) equipped with an articulated chain (2) having a free end (3), characterized in that it comprises a guide device (10) comprising:
a fixed surface (11),
a guide means (20) mounted on the fixed surface by a ball joint (21),
a rod (30) mounted on the guide means (20) by means of a sliding connection (25) having an axis corresponding to the axis of the rod (30), the rod comprising a first end (32) and a second end (33) fixedly mounted on the free end (3) of the haptic device (1), a grip member (5) being intended to be mounted on the second end.
2. The control interface (I) according to claim 1, further comprising said grip member (5), said grip member (5) and said stem (30) respectively comprising detection means (6, 40) able to detect the pressure exerted by the user on said grip member.
3. Control interface (I) according to claim 2, characterized in that the first detection means (6) is a magnet and the second detection means (40) is a hall effect sensor.
4. Control interface (I) according to claim 3, characterized in that said gripping member (5) comprises a deformable gripper (8) and a movable portion (7) on which said magnet (6) is fixedly mounted, said movable portion (7) being displaceable when said gripper (8) is deformed.
5. The control interface (I) according to any one of claims 3 to 4, characterised in that said lever (30) is in the form of a hollow body internally delimiting a housing (34), said second detection means (40) being provided in said housing (34).
6. The control interface (I) according to any one of the preceding claims, characterised in that the fixing surface (11) comprises an opening (12) and the guiding means (20) comprise a spherical member (23) and an element (22) for fitting the spherical member into the opening (12), the fitting element (22) and the spherical member (23) forming the ball joint (21).
7. Control interface (I) according to claim 6, characterized in that the rod (30) is cylindrical, the spherical element (23) being hollow and having a sliding bearing (24) matching the shape of the rod (30) to form a sliding connection (25).
8. Control interface (I) according to any one of claims 5 to 7, characterized in that said lever (30) comprises supply means (41) for second detection means (40) arranged in said housing (34), said supply means (41) being electrically connected to said second detection means and being able to receive an electrical Signal (SE) emitted by said second detection means (40) when a user exerts a pressure on said grip member (5).
9. The control interface (I) according to the preceding claim, wherein the guide device (10) comprises a rotary collector (44) arranged coaxially around the rod (30), the collector (44) comprising an inner ring (44 a) attached to the rod (30) and an outer ring (44 b) attached to the shaft of the articulated chain (2) on which the free end (3) of the haptic device (1) is located.
10. The control interface (I) according to any one of claims 2 to 9, comprising an aseptic cover (15) interposed between the grip member (5) and the second end (33) of the stem.
11. A robotic System (SR) for vitreoretinal surgery, comprising:
a robotic Platform (PR) comprising at least one robotic arm (BR) for carrying at least one surgical instrument, the robotic arm (BR) comprising an actuation module comprising at least one actuator,
a console (60) comprising a control interface (I) for a robotic platform according to any of the preceding claims,
a therapy Module (MT) connected to the control interface (I) and the actuation module by a communication network, the therapy Module (MT) comprising at least one processor (52), a memory (53) and software for analyzing measurements performed by the haptic device (1) and for calculating and providing motion set points to the robotic arm (BR),
the platform is configured such that the motion applied to the rod (30) is reproduced on the surgical instrument by means of the robotic arm (BR).
12. The robotic System (SR) according to claim 11 when depending on claims 2 to 10, characterized in that the robotic System (SR) is configured such that the pressure exerted on the gripping member (5) and the movement applied to the gripping member are reproduced by a surgical instrument by means of the robotic arm (BR).
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FR2004321A FR3109717B1 (en) | 2020-04-30 | 2020-04-30 | CONTROL INTERFACE AND ROBOTIZED SYSTEM COMPRISING SUCH A CONTROL INTERFACE |
FRFR2004321 | 2020-04-30 | ||
PCT/EP2021/061439 WO2021219863A1 (en) | 2020-04-30 | 2021-04-30 | Control interface and robotic system comprising such a control interface |
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CN115605155A true CN115605155A (en) | 2023-01-13 |
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EP (1) | EP4142632A1 (en) |
CN (1) | CN115605155A (en) |
FR (1) | FR3109717B1 (en) |
WO (1) | WO2021219863A1 (en) |
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WO2016069989A1 (en) * | 2014-10-30 | 2016-05-06 | Intuitive Surgical Operations, Inc. | System and method for an articulated arm based tool guide |
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US6063095A (en) | 1996-02-20 | 2000-05-16 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US9579088B2 (en) * | 2007-02-20 | 2017-02-28 | Board Of Regents Of The University Of Nebraska | Methods, systems, and devices for surgical visualization and device manipulation |
KR101213452B1 (en) * | 2010-08-27 | 2012-12-18 | 한양대학교 에리카산학협력단 | Master-slave system using 4-dof parallel mechanism |
CN103717355B (en) * | 2011-07-27 | 2015-11-25 | 洛桑联邦理工学院 | For the mechanical remote control operating means of remote control |
US10271914B2 (en) | 2015-02-11 | 2019-04-30 | University Of Utah Research Foundation | Microsurgical tool adapters, systems and related methods |
US10813710B2 (en) * | 2017-03-02 | 2020-10-27 | KindHeart, Inc. | Telerobotic surgery system using minimally invasive surgical tool with variable force scaling and feedback and relayed communications between remote surgeon and surgery station |
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- 2021-04-30 EP EP21721135.8A patent/EP4142632A1/en active Pending
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FR3109717A1 (en) | 2021-11-05 |
FR3109717B1 (en) | 2022-04-22 |
EP4142632A1 (en) | 2023-03-08 |
WO2021219863A1 (en) | 2021-11-04 |
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